Prevalence and characteristics of gastrointestinal infections in men who have sex with men diagnosed with rectal chlamydia infection in the UK: An 'unlinked anonymous' cross-sectional study

Gwenda Hughes*, Panida Silalang, John Were, Hemanti Patel, Tristan Childs, Sarah Alexander, Stephen Duffell, Cara Saxon, Cathy Ison, Holly Mitchell, Nigel Field, Claire Jenkins

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

17 Citations (Scopus)


Introduction Gastrointestinal infections (GII) can cause serious ill health and morbidity. Although primarily transmitted through faecal contamination of food or water, transmission through sexual activity is well described, especially among men who have sex with men (MSM). Methods We investigated the prevalence of GIIs among a convenience sample of MSM who were consecutively diagnosed with rectal Chlamydia trachomatis (CT) at 12 UK genitourinary medicine clinics during 10 weeks in 2012. Residual rectal swabs were coded, anonymised and tested for Shigella, Campylobacter, Salmonella, Shiga toxin-producing Escherichia coli and enteroaggregative E. coli (EAEC) using a real-time PCR. Results were linked to respective coded and anonymised clinical and demographic data. Associations were investigated using Fisher's exact tests. Results Of 444 specimens tested, overall GII prevalence was 8.6% (95% CI 6.3% to 11.6%): 1.8% (0.9% to 3.6%) tested positive for Shigella, 1.8% (0.9% to 3.6%) for Campylobacter and 5.2% (3.5% to 7.7%) for EAEC. No specimens tested positive for Salmonella or other diarrhoeagenic E. coli pathotypes. Among those with any GII, 14/30 were asymptomatic (2/7 with Shigella, 3/6 with Campylobacter and 9/17 with EAEC). Shigella prevalence was higher in MSM who were HIV-positive (4.7% (2.1% to 10.2%) vs 0.5%(0.1% to 3.2%) in HIV-negative MSM; p=0.01). Conclusions In this small feasibility study, MSM with rectal CT appeared to be at appreciable risk of GII. Asymptomatic carriage may play a role in sexual transmission of GII.

Original languageEnglish
Pages (from-to)518-521
Number of pages4
JournalSexually Transmitted Infections
Issue number7
Publication statusPublished - 1 Nov 2018

Bibliographical note

Funding Information:
The authors gratefully acknowledge current and past members of the UK LGV Case-Finding Group who contributed data, specimens and expertise: Sameena Ahmad (University Hospitals of South Manchester National Health Service (NHS) Foundation Trust, Manchester, UK); Nadia Ahmed, Patrick French (Central and North West London NHS Foundation Trust, London, UK); Pamela Saunders and Sinan Turkaslan (Sexually Transmitted Bacteria Reference Unit, Public Health England, Colindale, London); Tristan Childs, Stephen Duffell, Rishma Maini, Chinelo Obi, Parnam Seyan (Centre for Infectious Disease Surveillance and Control, PHE Colindale); Sara Day, Jamie Hardie, Ken McKlean, Alan McOwan, Christopher Scott, Richard Stack, Ann Sullivan (Chelsea and Westminster Hospital NHS Foundation Trust, London); Gillian Dean, Mohammed Hassan-Ibrahim, Gary Homer (Brighton and Sussex University Hospitals NHS Trust, Brighton, UK); Kirstine Eastick (Scottish Bacterial Sexually Transmitted Infections Reference Laboratory, Health Protection Scotland, Edinburgh, Scotland, UK); Laura Greaves, Maria Sampson, Merle Symonds (Barts Health NHS Trust, London); Rory Gunson, Anthony Rea, Andrew Winter (NHS Greater Glasgow and Clyde Health Board, Glasgow, Scotland, UK); Peter Horne, Daniel Krahe, Iain Reeves (Homerton University Hospital NHS Foundation Trust, London); Monica Rebec, Javier Rubio, Dawn Wilkinson (Imperial College Healthcare NHS Trust, London); Gabriel Schembri, Peter Tilston, Andrew Turner (Central Manchester University Hospitals NHS Foundation Trust); Simon Stevenson (University College London Hospitals NHS Foundation Trust); Helen Ward (Imperial College London); John White (Guy's and St Thomas' NHS Foundation Trust, London).

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